TdC 304: Reposição de fluidos - 5 armadilhas

O Curso TdC de Atualização vai reunir aulas sobre os temas mais frequentes da clínica médica, organizadas para você aprender o que mudou e transformar novas evidências em melhores decisões à beira do leito ou no consultório. Para ativar a notificação da live de lançamento com direito ao desconto imperdível, é só clicar no link abaixo:https://www.youtube.com/watch?v=i_uiG8cKJ3U 🚨 www.tadeclinicagem.com.br/guia - Conheça o Guia TdC com 7 dias grátis 🚨Jonatas Zanoveli, Lucca Cirillo e Iaaaaaago Jorge conversam sobre 5 clinicagens na reposição de fluidos:- Fluido também é remédio- O soro fisiológico não é tão fisiológico- Soro fisiológico vs Ringer lactato e outras soluções balanceadas- Há espaço para albumina como expansor?- Soro glicosado nutre?Minutagem:00:10 Apresentação03:03 Clinicagem 1 - Fluido também é remédio15:39 Clinicagem 2 - O soro fisiológico não é tão fisiológico21:19 Clinicagem 3 - Soro fisiológico vs Ringer lactato e outras soluções balanceadas34:47 Clinicagem 4 - Há espaço para albumina como expansor?44:47 Clinicagem 5 - Soro glicosado nutre?Referências:1. Malbrain, Manu L N G et al. “Principles of fluid management and stewardship in septic shock: it is time to consider the four D's and the four phases of fluid therapy.” Annals of intensive care vol. 8,1 66. 22 May. 2018, doi:10.1186/s13613-018-0402-x2. https://www.gov.br/anvisa/pt-br/assuntos/medicamentos/bulas-e-rotulos/especificos/arquivos/6440json-file-13. Rajasekaran, Arun et al. “Lactated Ringer's solution and risk of hyperkalemia in patients with reduced kidney function.” The American journal of the medical sciences vol. 364,4 (2022): 433-443. doi:10.1016/j.amjms.2022.04.0244. Tseng, Chien-Hua et al. “Impact of Comorbidities on Beneficial Effect of Lactated Ringers vs. Saline in Sepsis Patients.” Frontiers in medicine vol. 8 758902. 13 Dec. 2021, doi:10.3389/fmed.2021.7589025. Figge, James J. “Integration of acid-base and electrolyte disorders.” The New England journal of medicine vol. 372,4 (2015): 390. doi:10.1056/NEJMc14147316. Franchini, Stefano. “Physiological approach to assessment of acid-base disturbances.” The New England journal of medicine vol. 372,2 (2015): 193-4. doi:10.1056/NEJMc14138807. Lehtiranta, Saara et al. “Risk of Electrolyte Disorders in Acutely Ill Children Receiving Commercially Available Plasmalike Isotonic Fluids: A Randomized Clinical Trial.” JAMA pediatrics vol. 175,1 (2021): 28-35. doi:10.1001/jamapediatrics.2020.33838. https://www.azivmedics.com/iv-fluids9. https://www.nyp-cc.com/dart/iv-fluid-selection10. Castera, Mark R. and Mahesh B. Borhade . “Fluid Management.” StatPearls, StatPearls Publishing, 29 April 2025.11. https://link.springer.com/book/10.1007/978-3-031-42205-8#about-this-book12. Malbrain, Manu L N G et al. “Principles of fluid management and stewardship in septic shock: it is time to consider the four D's and the four phases of fluid therapy.” Annals of intensive care vol. 8,1 66. 22 May. 2018, doi:10.1186/s13613-018-0402-x13. Malbrain ML, Wong A, Nasa P, Ghosh S. Rational use of intravenous fluids in critically ill patients. Springer Nature; 2024.14. Joannidis M, Wiedermann CJ, Ostermann M. Ten myths about albumin. Intensive care medicine. 2022 May;48(5):602-5.15. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/207449Orig1s000lbl.pdf16. Finfer S, Bellomo R, Boyce N, French J, Myburgh J, Norton R: A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med. 2004, 350:2247-56. 10.1056/NEJMoa04023217. Finfer S, McEvoy S, Bellomo R, McArthur C, Myburgh J, Norton R: Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis. Intensive Care Med. 2011, 37:86-9. 10.1007/s00134-010-2039-618. Caironi P, Tognoni G, Masson S, Fumagalli R, Pesenti A, Romero M, Fanizza C, Caspani L, Faenza S, Grasselli G, Iapichino G. Albumin replacement in patients with severe sepsis or septic shock. New England Journal of Medicine. 2014 Apr 10;370(15):1412-21.19. Lewis SR, Pritchard MW, Evans DJ, Butler AR, Alderson P, Smith AF, Roberts I. Colloids versus crystalloids for fluid resuscitation in critically ill people. Cochrane Database of Systematic Reviews. 2018(8).20. Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, Machado FR, Mcintyre L, Ostermann M, Prescott HC, Schorr C. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Critical care medicine. 2021 Nov 1;49(11):e1063-143.21. Yu YT, Liu J, Hu B, Wang RL, Yang XH, Shang XL, et#al. Expert consensus on the use of human serum albumin in critically ill patients. Chin Med J. 2021;134(14):1639–5422. Hryciw N, Joannidis M, Hiremath S, Callum J, Clark EG: Intravenous albumin for mitigating hypotension and augmenting ultrafiltration during kidney replacement therapy. Clin J Am Soc Nephrol. 2020, 10.2215/CJN.0967062023. Annane D, Siami S, Jaber S, et al.: Effects of fluid resuscitation with colloids vs crystalloids on mortality in critically ill patients presenting with hypovolemic shock: the CRISTAL randomized trial. JAMA. 2013, 310:1809-17. 10.1001/jama.2013.28050224. http://bvsms.saude.gov.br/bvs/publicacoes/dengue_ diagnostico_manejo_clinico_6ed.pdf